Septal superior exposure of the mitral valve the transplant approach

The technique used for transplant recipient cardiectomy can be modified to improve exposure of the mitral valve in patients with difficult anatomy. Right atrial and septal incisions are joined at the superior end of the interatrial septum and extended across the dome of the left atrium to the base of the left atrial appendage. Retraction of the right ventricle to the left bivalves the left atrium along an axis extending from the appendage to the inferior end of the septum, producing uniquely anterosuperior exposure of the mitral apparatus